The federal government will no longer tie physician payments to vaccination rates and is advising state health agencies to discontinue similar incentive programs.
In a Dec. 30, 2025, memo to state health officials, the Centers for Medicare & Medicaid Services said it “does not tie payment to performance on immunization quality measures in Medicaid and CHIP at the federal level.” U.S. Health Secretary Robert F. Kennedy Jr. said the new policy protects medical freedom and informed consent.
“This directional change coming from CMS is welcome,” said Mary Holland, CEO of Children’s Health Defense. “It helps to put vaccines back into the category of every other medical intervention, which is where they should be.”
The incentive program, which offered pediatricians and family doctors modest financial rewards for meeting vaccine coverage benchmarks, was originally designed to boost immunization rates and reduce the spread of preventable diseases. Many states and private insurers have relied on similar frameworks since the 1990s, contributing to historically high vaccination rates for diseases such as measles, polio, and whooping cough.
‘Financial incentives distort medical judgment’
Financial incentives can distort medical judgment when they create a conflict between what is best for the patient and what is financially best for the clinician or organization.
- Financial incentives are payments, bonuses, or penalties tied to how doctors practice (for example, how many procedures they do, how many tests they order, or how much they save an insurer).
- Medical judgment should be guided by evidence and patient welfare, not by how a choice affects income, bonuses, or clinic revenue.
“This directional change coming from CMS is welcome,” said Mary Holland, CEO of Children’s Health Defense. “It helps to put vaccines back into the category of every other medical intervention, which is where they should be.”
Public health advocates, however, say the shift could strengthen transparency and address growing public skepticism about vaccine recommendations. “Removing financial incentives helps rebuild trust at a critical moment,” said Dr. Joanne Kim, director of the National Public Health Forum.
While HHS has not detailed whether supplemental funding will replace the lost incentives, officials said new initiatives focusing on education, community engagement, and local partnerships will roll out later this year.
The change comes amid ongoing national debates over medical transparency, vaccine mandates, and physician incentives — all key factors shaping how Americans approach preventive healthcare and parental consent in the coming decade.
